Abstract 425P
Background
Palonosetron (PALO) is a second-generation 5-hydroxytryptamine 3 receptor antagonist (5HT3RA) that has shown better efficacy than first-generation 5HT3RA (granisetron; GRA) in preventing chemotherapy-induced nausea and vomiting (CINV). PALO is usually administrated repeatedly when the patients have no nausea even though it is expensive as compared with GRA. However, we could reduce medical costs for chemotherapy if 5HT3RA conversion from PALO to GRA in the patient without having CINV is safe and tolerable.
Methods
We prospectively investigated patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC) in combination with PALO for digestive organ cancers in accordance with guideline of Japan Society of Clinical Oncology. Patients assessed as complete response (CR) during the acute phase (0-24 h postchemotherapy) and the delayed phase (24-120 h postchemotherapy) in consecutive treatments were converted their antiemetic agents from PALO to GRA. We evaluated the incidence of CINV and the cost-effectiveness.
Results
Thirty five cases (madian age 73 years, female 51.4%, 18; pancreatic cancer, 8; colorectal cancer, 3; esophageal cancer, 3; gastric cancer, 3; biliary tract cancer) were enrolled at our institution between January 2018 and June 2019. Ten cases were administrated HEC (HEC group) and 25 cases were administrated MEC (MEC group). One case of HEC group and 2 cases of MEC group changed their chemotherapy regimens due to adverse events and progression of disease. Four cases of HEC group (40.0%) and 14 cases of MEC group (56.0%) were assessed as CR in consecutive treatments, thereafter their antiemetic agents were converted from PALO to GRA in the subsequent treatments. All of them continued their chemotherapy without the incidence of nausea and vomiting. Among the cases assessed as CR, we could save 111,935 Japanese yen (1,034.6 USD, range, 13,868-194,152 JPY) per case by conversion of 5HT3RA.
Conclusions
Our data indicated that the conversion of 5HT3RA is safe and also provide economic benefit in patients receiving HEC or MEC. When patients receiving HEC or MEC with PALO were assessed as CR, we should consider conversion of 5HT3RA.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Asahikawa medical University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
205P - Treatment pattern and outcomes of radium-223 (Ra223) in metastatic castration resistant prostate cancer (mCRPC): Retrospective cohort analysis from Hong Kong
Presenter: Darren Poon
Session: Poster display session
Resources:
Abstract
206P - Population-based validation of the risk stratification among prostate cancer patients
Presenter: Mu Xie
Session: Poster display session
Resources:
Abstract
211P - Adjuvant axitinib in Asian vs non-Asian patients with metastatic renal cell carcinoma (mRCC): ATLAS trial subgroup analysis
Presenter: Chi Fai Ng
Session: Poster display session
Resources:
Abstract
212P - Immunotherapy with nivolumab in metastatic renal cell carcinoma patients in India: Bringing a change in clinical practice
Presenter: Amit Rauthan
Session: Poster display session
Resources:
Abstract
213P - An observational retrospective real-world study of sarcomatoid renal cell carcinoma (sRCC) patients in an Asian cancer centre
Presenter: Ravindran Kanesvaran
Session: Poster display session
Resources:
Abstract
214P - Targeting epithelial-mesenchymal transition (EMT), novel strategy to delay resistance or re-sensitize renal cancer to Sunitinib
Presenter: Revati Sharma
Session: Poster display session
Resources:
Abstract
215P - Radiologic and pathologic tumour size variation in localized renal cell carcinoma and its implications
Presenter: Shanky Singh
Session: Poster display session
Resources:
Abstract
216P - Partial versus radical nephrectomy: 10- year long-term survival among patients with Wilms tumour
Presenter: Mira Mostafa
Session: Poster display session
Resources:
Abstract
217P - Neutrophil-to-lymphocyte ratio is a useful biomarker for predicting worse clinical outcome in chemo-resistant urothelial carcinoma patients treated with pembrolizumab
Presenter: Koichiro Ogihara
Session: Poster display session
Resources:
Abstract
219P - Long-term outcomes of bladder preservation in muscle-invasive bladder cancer patients
Presenter: Amanda Dania Satiti
Session: Poster display session
Resources:
Abstract